Fitness Assessment Survey Fitness Assessment Survey Pre-Assessment Survey for Fitness Assessment by Forever Free Fitness Step 1 of 3 33% The mission of Forever Free Fitness is to help as many people as possible achieve the benefits of a healthy lifestyle. Please complete this form prior to your scheduled new client fitness assessment.Name(Required) First Last Email(Required) Phone(Required)Age(Required) Occupation(Required) Describe Your Lifestyle(Required) Active Sedentary How did you hear about Forever Free Fitness?(Required) Friend/Family Facebook Flyer Existing Member Other Referring Member(Required) Other Your GoalsWhy did you decide to schedule an assessment?(Required)Is there something happening in your life that you want to look or feel particularly good for?(Required) Yes No Explain: What else do you want to accomplish in terms of your health?(Required) Weight Loss Weight Gain Tone & Firm Reduce Stress Other Other Goal What particular area(s) would you like to target for improvement? Arms Chest Legs Other Other target area(s) Do you have any poor health habits you’d like to change?(Required) Yes No Describe the health habits you'd like to change. How long have you been thinking about beginning or getting back on a regular fitness program?(Required) During that time, what's kept you from getting started before today?(Required) How much time you are willing to commit to exercising in order to reach your goals? 1-3 hours per week 3-5 hours per week 5+ hours per week Your Fitness JourneyWhen was the last time you were in the shape you want to be in? MM slash DD slash YYYY What dress/pants size were you then?(Required) How did you feel?(Required) Who will be supporting your efforts to achieve your goals?(Required) GUEST ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY(Required) I, the undersigned, do hereby acknowledge that use of Forever Free Fitness’s facilities, services, equipment or premises involves risk of injury to my my property, and that as a condition to use the facility I assume full responsibility for such risks. I herby release and hold harmless Forever Free Fitness, agents, related entities and employees from all liability to me, my heirs and assigns for any loss or damage to me, and forever give up any claims account of injury to my person or property whether caused by the active or passive negligence of Forever Free Fitness.Typed Signature(Required)
